| Advance care planning first 30 mins (99497) |
$143.40 |
$239 |
1.3× |
| Aerosol inhalation pentamidine (94642) |
$183.60 |
$306 |
0.8× |
| Airway inhalation treatment (94640) |
$60 |
$100 |
0.3× |
| Allergy injection single (95115) |
$20.40 |
$34 |
0.4× |
| Application of a modality to 1 or more areas; contrast baths, each 15 minutes Other Outpatient (97034) |
$42 |
$70 |
— |
| Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) |
$58.20 |
$97 |
— |
| Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) |
$65.40 |
$109 |
— |
| Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) |
$51.60 |
$86 |
— |
| Assessment of aphasia (96105) |
$135 |
$225 |
— |
| Behavioral & qualit analysis voice and resonance (92524) |
$166.80 |
$278 |
— |
| Bipap initial day (94660) |
$390.60 |
$651 |
1.7× |
| Breathing capacity test (94010) |
$113.70 |
$189.50 |
0.5× |
| Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) |
$348.60 |
$581 |
0.9× |
| Car seat/bed test inft thru 12 mo 60 min (94780) |
$92.40 |
$154 |
2.3× |
| Cardiovascular stress test (93017) |
$737.10 |
$1,228.50 |
3.2× |
| Cardioversion elective external (92960) |
$461.70 |
$769.50 |
0.7× |
| Chemo anti-neopl sq/im (96401) |
$112.20 |
$187 |
1.5× |
| Chemo hormon antineopl sq/im (96402) |
$65.40 |
$109 |
0.9× |
| Chemo IV infus each addl seq (96417) |
$171.60 |
$286 |
2.3× |
| Chemo IV infusion addl hr (96415) |
$90 |
$150 |
1.2× |
| Chemo IV push addl drug (96411) |
$112.20 |
$187 |
1.5× |
| Chemother prolong infuse w/pump (96416) |
$511.20 |
$852 |
1.5× |
| Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) |
$395.40 |
$659 |
1.1× |
| Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) |
$247.80 |
$413 |
0.7× |
| Chest physiotherapy initial (94667) |
$54 |
$90 |
0.4× |
| Chiropract manj 1-2 regions (98940) |
$41.40 |
$69 |
1.8× |
| Chiropract manj 3-4 regions (98941) |
$62.40 |
$104 |
2.7× |
| Chiropractic manipulative treatment (CMT); spinal, 5 regions (98942) |
$83.40 |
$139 |
3.7× |
| Chron care mgmt srvc 20 min (99490) |
$70.20 |
$117 |
0.7× |
| Color/duplex Doppler, complete (93975) |
$910.80 |
$1,518 |
3.6× |
| Color/duplex Doppler, limited (93976) |
$256.80 |
$428 |
2.3× |
| Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or… (97537) |
$53.40 |
$89 |
— |
| Concurrent chemotherapy (96549) |
$61.20 |
$102 |
1.2× |
| Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) |
$133.20 |
$222 |
0.9× |
| Cpr (92950) |
$642 |
$1,070 |
2.8× |
| Critical care ill/injured patient init 30-74 min (99291) |
$556.80 |
$928 |
0.6× |
| Debridement open wound 20 sq cm< (97597) |
$96.60 |
$161 |
0.5× |
| Delivery/birthing room resuscitation (99465) |
$246 |
$410 |
0.4× |
| Duplex hemodialysis access (93990) |
$228.60 |
$381 |
2.1× |
| Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study Age Under 21 (93978) |
$574.80 |
$958 |
2.3× |
| Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study Age Under 21 (93979) |
$298.80 |
$498 |
2.7× |
| Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) |
$589.20 |
$982 |
2.3× |
| Duplex scan of extracranial arteries; unilateral or limited study Age Under 21 (93882) |
$310.80 |
$518 |
2.8× |
| Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) |
$619.20 |
$1,032 |
2.5× |
| Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) |
$454.80 |
$758 |
4.1× |
| Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) |
$860.40 |
$1,434 |
3.4× |
| Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) |
$400.20 |
$667 |
3.6× |
| Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) |
$663 |
$1,105 |
2.6× |
| Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) |
$294 |
$490 |
2.7× |
| ECG monit/reprt up to 48 hrs (93226) |
$267 |
$445 |
4.3× |
| ECG/monitoring and analysis (93271) |
$1,606.80 |
$2,678 |
16.0× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) |
$826.80 |
$1,378 |
1.4× |
| EKG 12 lead tracing only (93005) |
$105.30 |
$175.50 |
1.7× |
| EKG rhythm strip (93041) |
$69 |
$115 |
1.1× |
| Elec alys implt npgt cplx sp/pn prgrmg (95972) |
$209.40 |
$349 |
2.1× |
| Emergency department visit high mdm (99285) |
$391.50 |
$652.50 |
0.6× |
| Emergency department visit low mdm (99283) |
$252 |
$420 |
0.9× |
| Emergency department visit may not req phys/qhp (99281) |
$80.10 |
$133.50 |
0.9× |
| Emergency department visit moderate mdm (99284) |
$261.90 |
$436.50 |
0.6× |
| Emergency department visit straightforward mdm (99282) |
$156 |
$260 |
1.0× |
| End tidal co2 mntrng (crbn dxde exp gas dtrmntn by infrared analyzer) (94799) |
$42.30 |
$70.50 |
0.3× |
| Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) |
$117 |
$195 |
— |
| Evaluate pt use of inhaler (94664) |
$160.50 |
$267.50 |
0.7× |
| Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92608) |
$104.40 |
$174 |
— |
| Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with… (92607) |
$249 |
$415 |
— |
| Evaluation of speech fluency (92521) |
$218.40 |
$364 |
— |
| Evaluation of speech sound production articulate (92522) |
$163.20 |
$272 |
— |
| External ECG rec>48hr<7d recording (93242) |
$106.80 |
$178 |
2.7× |
| External ECG rec>7d<15d recording (93246) |
$88.20 |
$147 |
2.2× |
| Gas dilut/washout lung vol w/wo distrib vent&vol (94727) |
$222 |
$370 |
1.0× |
| Hemodialysis procedure w/ phys/qhp evaluation (90935) |
$224.40 |
$374 |
0.3× |
| Im adm intransl/oral 1 vaccine (90473) |
$9 |
$15 |
0.1× |
| Immunization administration (90471) |
$20.70 |
$34.50 |
0.3× |
| Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant (99460) |
$133.20 |
$222 |
0.9× |
| Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and… (99463) |
$150.30 |
$250.50 |
1.1× |
| Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) |
$72.60 |
$121 |
1.5× |
| Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) |
$117 |
$195 |
0.5× |
| Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes with Cardiac Cath (93503) |
$144.60 |
$241 |
0.1× |
| Irrigaj implntd venous access drug delivery syst (96523) |
$52.80 |
$88 |
0.8× |
| IV infusion hydration each additional hour (96361) |
$60 |
$100 |
1.2× |
| IV infusion hydration initial 31 min-1 hour (96360) |
$118.20 |
$197 |
0.5× |
| IV infusion ther proph addl sequential to 1 hr (96367) |
$80.40 |
$134 |
1.1× |
| IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) |
$189 |
$315 |
0.8× |
| IV tx, each additional hour (96366) |
$67.80 |
$113 |
1.4× |
| Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) |
$34.80 |
$58 |
0.2× |
| Mechanical traction therapy (97012) |
$78 |
$130 |
— |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) |
$26.40 |
$44 |
— |
| Medical nutrition group (97804) |
$61.20 |
$102 |
— |
| Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes… (97803) |
$22.20 |
$37 |
— |
| Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) |
$141 |
$235 |
— |
| Neg pressure wound therapy non dme </= 50 sq cm (97607) |
$31.80 |
$53 |
0.1× |
| Negative pressure wound therapy dme </= 50 sq cm (97605) |
$116.40 |
$194 |
0.5× |
| Non-invasive physiologic study extremity 3 levels (93923) |
$222.60 |
$371 |
1.0× |
| Noninvasive ear/pulse oximetry overnight monitor (94762) |
$173.40 |
$289 |
1.3× |
| Occupational therapy eval high complex 60 mins (97167) |
$154.80 |
$258 |
— |
| Occupational therapy eval low complex 30 mins (97165) |
$154.80 |
$258 |
— |
| Occupational therapy eval mod complex 45 mins (97166) |
$154.80 |
$258 |
— |
| Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program;… (92002) |
$201.60 |
$336 |
1.4× |
| Oral function therapy (92526) |
$117 |
$195 |
— |
| Oral speech device eval (92597) |
$175.20 |
$292 |
— |
| Orthc/prostc mgmt sbsq enc (97763) |
$76.80 |
$128 |
— |
| Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) |
$73.80 |
$123 |
— |
| Osteopath manj 1-2 regions (98925) |
$43.80 |
$73 |
1.9× |
| Osteopath manj 3-4 regions (98926) |
$64.80 |
$108 |
2.8× |
| Osteopath manj 9-10 regions (98929) |
$127.80 |
$213 |
5.6× |
| Osteopathic manipulative tx 5-6 body regions (98927) |
$85.20 |
$142 |
3.7× |
| Osteopathic manipulative tx 7-8 body regions (98928) |
$105.60 |
$176 |
4.6× |
| Ot manual therapy ea 15 min (97140) |
$78.60 |
$131 |
— |
| Ot neuromuscular re-education (97112) |
$94.80 |
$158 |
— |
| Ot paraffin bath (97018) |
$33 |
$55 |
— |
| Ot re-evaluation (97168) |
$79.20 |
$132 |
— |
| OT Therapeutic Activities Charges (97530) |
$54 |
$90 |
— |
| Ot wheelchair management (97542) |
$53.40 |
$89 |
— |
| Outpatient cardiac rehab w/cont ECG monitoring (93798) |
$25.80 |
$43 |
0.2× |
| Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education,… (94015) |
$210 |
$350 |
0.9× |
| Phlebotomy therapeutic (99195) |
$114 |
$190 |
0.8× |
| Phy/qhp op pulm rhb w/mntr (94626) |
$87.60 |
$146 |
1.4× |
| Physical therapy evaluation high complex 45 mins (97163) |
$291.60 |
$486 |
— |
| Physical therapy evaluation low complex 20 mins (97161) |
$291.60 |
$486 |
— |
| Physical therapy evaluation mod complex 30 mins (97162) |
$291.60 |
$486 |
— |
| Pm device progr eval multi (93281) |
$107.40 |
$179 |
2.7× |
| Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) |
$2,423.40 |
$4,039 |
2.7× |
| Polysom <6 yrs sleep w/cpap/bilvl vent 4/> param (95783) |
$1,938.60 |
$3,231 |
2.1× |
| Prgrmg dev eval pm/ldls pm (93279) |
$74.40 |
$124 |
1.9× |
| Professional services for allergen immunotherapy; 2 or more injections (95117) |
$33 |
$55 |
0.7× |
| Program eval implantable in persn dual ld pacer (93280) |
$87 |
$145 |
2.2× |
| Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93282) |
$111 |
$185 |
2.8× |
| Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93285) |
$76.80 |
$128 |
2.0× |
| Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93284) |
$132.60 |
$221 |
3.4× |
| Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93283) |
$120 |
$200 |
3.0× |
| Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) |
$81 |
$135 |
— |
| Pt gait training 15 min (97116) |
$52.80 |
$88 |
— |
| Pt physical performance test (97750) |
$79.80 |
$133 |
— |
| Pt re-evaluation (97164) |
$133.20 |
$222 |
— |
| Pulm funct tst plethysmograp (94726) |
$465.60 |
$776 |
1.2× |
| Pulmonary stress testing (94618) |
$147.60 |
$246 |
1.1× |
| Refilling and maintenance of portable pump (96521) |
$288 |
$480 |
1.3× |
| Respiratory flow volume loop (94375) |
$51.60 |
$86 |
0.2× |
| Review patient spirometry (94016) |
$35.40 |
$59 |
— |
| Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) |
$72.60 |
$121 |
— |
| Sleep study unattended (95806) |
$258.60 |
$431 |
1.1× |
| Speech sound lang comprehen (92523) |
$292.20 |
$487 |
— |
| Standardized cognitive performance testing (96125) |
$199.20 |
$332 |
— |
| Temp transcutaneous pacing (92953) |
$25.20 |
$42 |
0.0× |
| Ther ivntj cog funcj cntct 1st 15 minutes (97129) |
$50.40 |
$84 |
— |
| Ther ivntj cog funcj cntct ea addl 15 minutes (97130) |
$50.40 |
$84 |
— |
| Therapeutic procedure(s), group (2 or more individuals) Other Outpatient (97150) |
$42 |
$70 |
— |
| Therapeutic prophylactic/dx injection subq/im (96372) |
$22.20 |
$37 |
0.3× |
| Therapeutic services for the use of speech-generating device, including programming and modification Other Outpatient (92609) |
$216.60 |
$361 |
— |
| Tobacco use cessation intensive >10 minutes (99407) |
$31.80 |
$53 |
0.8× |
| Tobacco use cessation intermediate 3-10 minutes (99406) |
$19.80 |
$33 |
0.5× |
| Trans care mgmt 14 day disch (99495) |
$275.40 |
$459 |
2.0× |
| Trans care mgmt 7 day disch (99496) |
$388.20 |
$647 |
2.8× |
| Transcranial doppler stdy intracranial art compl (93886) |
$318.60 |
$531 |
1.3× |
| Tte f-up or lmtd (93308) |
$787.20 |
$1,312 |
3.1× |
| Tte w/doppler complete (93306) |
$1,323.60 |
$2,206 |
2.3× |
| Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) |
$94.20 |
$157 |
— |
| Tympanometry (92567) |
$34.80 |
$58 |
0.9× |
| Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion (96379) |
$61.20 |
$102 |
1.2× |
| Upr/l xtremity art 2 levels (93922) |
$610.80 |
$1,018 |
4.4× |
| Ventilation ip/obs initial day (94002) |
$98.10 |
$163.50 |
0.2× |
| Ventilator subsequent day (94003) |
$1,012.80 |
$1,688 |
1.6× |
| Wound(s) care non-selective (97602) |
$47.40 |
$79 |
0.2× |